RT Journal Article
SR Electronic
T1 Significantly increased risk of all-cause mortality among cardiac patients feeling lonely
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2019-315460
DO 10.1136/heartjnl-2019-315460
A1 Anne Vinggaard Christensen
A1 Knud Juel
A1 Ola Ekholm
A1 Lars Thrysøe
A1 Charlotte Brun Thorup
A1 Britt Borregaard
A1 Rikke Elmose Mols
A1 Trine Bernholdt Rasmussen
A1 Selina Kikkenborg Berg
YR 2019
UL http://heart.bmj.com/content/early/2019/09/24/heartjnl-2019-315460.abstract
AB Objective To explore whether living alone and loneliness 1) are associated with poor patient-reported outcomes at hospital discharge and 2) predict cardiac events and mortality 1 year after hospital discharge in women and men with ischaemic heart disease, arrhythmia, heart failure or heart valve disease.Methods A national cross-sectional survey including patients with known cardiac disease at hospital discharge combined with national register data at baseline and 1-year follow-up. Loneliness was evaluated using one self-reported question, and information on cohabitation was available from national registers. Patient-reported outcomes were Short Form-12, Hospital Anxiety and Depression Scale and HeartQoL. Clinical outcomes were 1-year cardiac events (myocardial infarction, stroke, cardiac arrest, ventricular tachycardia/fibrillation) and all-cause mortality from national registers.Results A total of 13 443 patients (53%) with ischaemic heart disease, arrhythmia, heart failure or heart valve disease completed the survey. Of these, 70% were male, and mean age was 66.1 among women and 64.9 among men. Across cardiac diagnoses, loneliness was associated with significantly poorer patient-reported outcomes in men and women. Loneliness predicted all-cause mortality among women and men (HR 2.92 (95% CI 1.55 to 5.49) and HR 2.14 (95% CI 1.43 to 3.22), respectively). Living alone predicted cardiac events in men only (HR 1.39 (95% CI 1.05 to 1.85)).Conclusions A strong association between loneliness and poor patient-reported outcomes and 1-year mortality was found in both men and women across cardiac diagnoses. The results suggest that loneliness should be a priority for public health initiatives, and should also be included in clinical risk assessment in cardiac patients.